Medial patellofemoral ligament issues and amputees
Use of allograft of the semitendonosis resulted in improved stability of the patellofemoral joint (PFJ) in a below knee amputee.
Instability of the paterllofemoral joint (PFJ) is fairly common in below knee amputees and some contributing factors are thought to be exasperated by influences such as; the use of patella-tendon bearing prosthetics, reduced loading in flexion and underlying congenital dysfunction.
The case study individual was suffering dislocation of the patella on a regular basis, although the prosthetic supplied to the individual was well fitted, scans showed changed in the PFJ region.
Medial patellofemoral ligament (MPFL) reconstruction has proved effective in abled bodied individuals with reoccurring PFJ instability and has been postulated as a solution for below knee amputees.
An allograft of the semitendinosus was used in the reconstruction, followed by 2 weeks of immobilisation (in extension). Physiotherapy was then used to return full mobility.
2 years post operativly the patient had no further occurrences of dislocation and the associated pains have resolved. The harvested soft tissue may not be suitable in every case and preoperative preparations and investigations are essential to a successful outcome.
Which muscles are most commonly used for allografts and why?
> From: El-Tawil et al., Case Rep Orthop 2015 (2015) 429463. All rights reserved to The Author(s). Click here for the Pubmed summary.